Early-Month Rx Fatalities Linked to Overworked Pharmacists

A beginning-of-the-month upsurgein the average pharmacist's workloadmay be at least partially responsible foran alarming increase in the nation'srate of drug-related deaths during thefirst few days of each month, pharmacyresearchers warned.

The new study, conducted byresearchers at the University of Californiain La Jolla and the Tufts UniversitySchool of Medicine in Boston, examinedmillions of death certificates from1979 to 2000 and discovered that"some types of fatal medication errorsspike by 25% above normal at thebeginning of the month."

Unable to explain the rise in drug-relatedfatalities by controlling for suchfactors as substance abuse or socioeconomicstatus, the researchers concludedthat the likely cause was overburdenedpharmacists faced with a sharpjump in prescription orders whenthose patients on welfare come topharmacies for medication when theirfirst-of-the-month checks arrive.

Because "there is an increasedpharmacy workload at the beginningof each month, some pharmacistsmay be unusually prone to error inthe filling and labeling of prescriptionsand may have less time thanusual to explain necessary precautionsto their patients,"researchers said in astudy published in the January 2005edition of Pharmacotherapy, the Journalof the American College of Clinical Pharmacy.

To reduce potentially fatal medicationerrors, the researchers suggested that:

• Patients "be especially careful tocheck the accuracy"of prescriptionsdispensed early in eachmonth
• Pharmacies consider increasingprescription department staff levelsat the beginning of the month
• Governments stagger payments towelfare recipients, Social Securitybeneficiaries, and others on assistanceover the entire month

Mr. Rankin is a freelance medical writer.